TODENTJ-25-03-2019_TODENTJ-7-94 1553505470 Bentham Open doi@benthamopen.net Bentham Open The Open Dentistry Journal TODENTJ 1874-2106 8 23 2013 7 1 Cornelio Blus Serge Szmukler-Moncler Giulio Giannelli Gloria Denotti Germano Orrù This preliminary work documents the use of a powerful piezosurgery device to treat biphosphonate-related osteonecrosis of the jaw (BRONJ) in combination with classical medication therapy. Eight patients presenting 9 BRONJ sites were treated, 2 in the maxilla and 7 in the mandible. Reason for biphosphonate (BiP) intake was treatment of an oncologic disease for 5 patients and osteoporosis for 3. The oncologic and osteoporosis patients were diagnosed with BRONJ after 35-110 months and 80-183 months of BiP treatment, respectively. BRONJ 2 and 3 was found in 4 patients. Resection of the bone sequestrae was performed with a high power ultrasonic (piezo) surgery and antibiotics were administrated for 2 weeks. Soft tissue healing was incomplete at the 2-week control but it was achieved within 1 month. At the 1-year control, soft tissue healing was maintained at all patients, without symptom recurrence. One patient with paraesthesia had abated; of the 2 pa-tients with trismus, one was healed, severity of the second trismus abated. This case report series suggests that bone resection performed with a high power ultrasonic surgery device combined with antibiotics might lead to BRONJ healing. More patients are warranted to confirm the present findings and assess this treatment approach. 8 23 2013 94 101 TODENTJ-7-94 1 10.2174/crossmark_policy opendentistryjournal.com benthamopen.com true Peer Reviewed Single blind Checked with iThenticate 2013-2-27 2013-4-16 2013-4-30 2013-8-23 http://creativecommons.org/licenses/by-nc/3.0/ 10.2174/1874210601307010094 1553505470 https://opendentistryjournal.com/VOLUME/7/PAGE/94/ https://opendentistryjournal.com/contents/volumes/V7/TODENTJ-7-94/TODENTJ-7-94.pdf https://opendentistryjournal.com/contents/volumes/V7/TODENTJ-7-94/TODENTJ-7-94.pdf https://opendentistryjournal.com/contents/volumes/V7/TODENTJ-7-94/TODENTJ-7-94.pdf https://opendentistryjournal.com/contents/volumes/V7/TODENTJ-7-94/TODENTJ-7-94.pdf https://opendentistryjournal.com/contents/volumes/V7/TODENTJ-7-94/TODENTJ-7-94.pdf https://opendentistryjournal.com/contents/volumes/V7/TODENTJ-7-94/TODENTJ-7-94.pdf https://opendentistryjournal.com/contents/volumes/V7/TODENTJ-7-94/TODENTJ-7-94.pdf https://opendentistryjournal.com/contents/volumes/V7/TODENTJ-7-94/TODENTJ-7-94.xml Protocol 19 Aredia Breast Cancer Study Group. J Clin Oncol Hortobagyi GN 16 2038 1998 Hortobagyi GN, Theriault RL, Lipton A. Long-term prevention of skeletal complications of metastatic breast cancer with pamidronate Protocol 19 Aredia Breast Cancer Study Group J Clin Oncol 1998; 16 (6 ) : 2038-44. J Clin Oncol Major P 19 558 2001 Major P, Lortholary A, Hon J. Zoledronic acid is superior to pamidronate in the treatment of hypercalcemia of malig-nancy: a pooled analysis of two randomized. controlled clinical trials J Clin Oncol 2001; 19 (2 ) : 558-67. J Clin Oncol Berenson JR 20 3719 2002 Berenson JR, Hillner BE, Kyle RA. American Society of Clinical Oncology clinical practice guidelines: the role of bisphosphonates in multiple myeloma J Clin Oncol 2002; 20 (17 ) : 3719-6. Cancer Rosen LS 100 2613 2004 Rosen LS, Gordon D, Tchekmedyian NS. Long-term efficacy and safety of zoledronic acid in the treatment of skeletal metastases in patients with nonsmall cell lung carcinoma and other solid tumors: a randomized. Phase III.double-blind., placebo-controlled trial Cancer 2004; 100 (12 ) : 2613-1. J Natl Cancer Inst Saad F 96 879 2004 Saad F, Gleason DM, Murray R. Long-term efficacy of zoledronic acid for the prevention of skeletal complications in patients with metastatic hormone-refractory prostate cancer J Natl Cancer Inst 2004; 96 (11 ) : 879-2. J Oral Maxillofac Surg Assael LA 67 35 2009 Assael LA. Oral bisphosphonates as a cause of bisphosphonate-related osteonecrosis of the jaws: clinical findings. assessment of rsks.and preventive strategies J Oral Maxillofac Surg 2009; 67 ( 5 Suppl) : 35-43. Ugeskr Laeg Sorensen OH 153 693 1991 Sorensen OH. [Biphosphonates--a new treatment in osteoporosis] Ugeskr Laeg 1991; 153 (10 ) : 693-4. Oncology (Williston Park) Van Poznak C 20 1053 2006 Van Poznak C, Estilo C. Osteonecrosis of the jaw in cancer patients receiving IV bisphosphonates Oncology (Williston Park) 2006; 20 (9 ) : 1053-62. Aust Endod J Ruggiero SL 35 119 2009 Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Mehrotra B. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaw - 2009 update Aust Endod J 2009; 35 (3 ) : 119-30. J Oral Maxillofac Surg Marx RE 61 1115 2003 Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic J Oral Maxillofac Surg 2003; 61 (9 ) : 1115-7. Oral Surg Oral Med Oral Pathol Oral Radiol Endod Moretti F 112 777 2011 Moretti F, Pelliccioni GA, Montebugnoli L, Marchetti C. A prospective clinical trial for assessing the efficacy of a min-imally invasive protocol in patients with bisphosphonate-associated osteonecrosis of the jaws Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112 (6 ) : 777-82. Minerva Stomatol Vescovi P 59 181 2010 Vescovi P, Nammour S. Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ) therapy.a critical review Minerva Stomatol 2010; 59 (4 ) : 181-203. Br J Oral Maxillofac Surg Vescovi P 45 628 2007 Vescovi P, Merigo E, Meleti M, Fornaini C, Nammour S, Manfredi M. Nd: YAG laser biostimulation of bisphos-phonate-associated necrosis of the jawbone with and without surgical treatment Br J Oral Maxillofac Surg 2007; 45 (8 ) : 628-32. YAG laser biostimulation in the treatment of bisphosphonate-associated osteonecrosis of the jaw: clinical experience in 28 cases. Photomed Laser Surg Vescovi P 26 37 2008 Vescovi P, Merigo E, Manfredi M. Nd YAG laser biostimulation in the treatment of bisphosphonate-associated osteonecrosis of the jaw: clinical experience in 28 cases Photomed Laser Surg 2008; 26 (1 ) : 37-46. J Oral Pathol Med Vescovi P 41 214 2012 Vescovi P, Merigo E, Meleti M, Manfredi M, Guidotti R, Nammour S. Bisphosphonates-related osteonecrosis of the jaws: a concise review of the literature and a report of a single-centre experience with 151 patients J Oral Pathol Med 2012; 41 (3 ) : 214-. J Oral Maxillofac Surg Carlson ER 67 85 2009 Carlson ER, Basile JD. The role of surgical resection in the management of bisphosphonate-related osteonecrosis of the jaws J Oral Maxillofac Surg 2009; 67 (5 Suppl ) : 85-95. J Oral Maxillofac Surg Stanton DC 67 943 2009 Stanton DC, Balasanian E. Outcome of surgical management of bisphosphonate-related osteonecrosis of the jaws: review of 33 surgical cases J Oral Maxillofac Surg 2009; 67 (5 ) : 943-50. J Oral Maxillofac Surg Freiberger JJ 65 1321 2007 Freiberger JJ, Padilla-Burgos R, Chhoeu AH, et al. Hyperbaric oxygen treatment and bisphosphonate-induced osteonecrosis of the jaw: a case series J Oral Maxillofac Surg 2007; 65 (7 ) : 1321-7. J Oral Maxillofac Surg Curi MM 69 2465 2011 Curi MM, Cossolin GS, Koga DH. Bisphosphonate-related osteonecrosis of the jaws--an initial case series report of treatment combining partial bone resection and autologous platelet-rich plasma J Oral Maxillofac Surg 2011; 69 (9 ) : 2465-72. J Bone Miner Metab Yoneda T 28 365 2010 Yoneda T, Hagino H, Sugimoto T. Bisphosphonate-related osteonecrosis of the jaw: position paper from the Allied Task Force Committee of Japanese Society for Bone and Mineral Research. Japan Osteoporosis Socety.Japanese Society of Periodontology., Japanese Society for Oral and Maxillofacial Radiology., and Japanese Society of Oral and Maxillofacial Surgeons J Bone Miner Metab 2010; 28 (4 ) : 365-83. Clin Oral Implants Res Blus C 17 700 2006 Blus C, Szmukler-Moncler S. Split-crest and immediate implant placement with ultra-sonic bone surgery: a 3-year life-table analysis with 230 treated sites Clin Oral Implants Res 2006; 17 (6 ) : 700-. Int J Periodontics Restorative Dent Blus C 28 221 2008 Blus C, Szmukler-Moncler S, Salama M, Salama H, Garber D. Sinus bone grafting procedures using ultrasonic bone surgery: 5-year experience Int J Periodontics Restorative Dent 2008; 28 (3 ) : 221-9. Biochim Biophys Acta Thacker J 304 240 1973 Thacker J. An approach to the mechanism of killing of cells in suspension by ultrasound Biochim Biophys Acta 1973; 304 (2 ) : 240-8. Int J Periodontics Restorative Dent Blus C 30 355 2010 Blus C, Szmukler-Moncler S. Atraumatic tooth extraction and immediate implant placement with Piezosurgery: evalua-tion of 40 sites after at least 1 year of loading Int J Periodontics Restorative Dent 2010; 30 (4 ) : 355-63. Clin Pediatr (Phila) Khan N 40 217 2001 Khan N, Licata A, Rogers D. Intravenous bisphosphonate for hypercalcemia accompanying subcutaneous fat necrosis a novel treatment approach Clin Pediatr (Phila) 2001; 40 (4 ) : 217-9. Acta Biomed Merigo E 77 109 2006 Merigo E, Manfredi M, Meleti M. Bone necrosis of the jaws associated with bisphosphonate treatment: a report of twenty-nine cases Acta Biomed 2006; 77 (2 ) : 109-7. Proceedings of the 2nd Congress of the World Union Wound Healing Socieies Blus C July 8-13. Paris. France. Poster AA 2004 p181 2004. Blus C, Szmukler-Moncler S, La Rosa A, Moia R. Ultra-sonic debridement.A novel approach of scar debridement Proceedings of the 2nd Congress of the World Union Wound Healing Socieies 2004.; July 8-13. Paris. France. Poster AA 2004 : p181. Clin Implant Dent Relat Res Blus C 15 2013 Blus C, Szmukler-Moncler S, Khoury PM, Piras V, Orrù G. Immediate implants placed in infected and non-infected sites after atraumatic tooth extraction and placement with piezo-surgery (ultra-sonic surgery) Clin Implant Dent Relat Res 2013; 15 J Periodontol Preti G 78 716 2007 Preti G, Martinasso G, Peirone B. Cytokines and growth factors involved in the osseointegration of oral titanium implants positioned using piezoelectric bone surgery versus a drill technique: a pilot study in minipigs J Periodontol 2007; 78 (4 ) : 716-22. J Oral Maxillofac Surg Sedghizadeh PP 66 767 2008 Sedghizadeh PP, Kumar SK, Gorur A, Schaudinn C, Shuler CF, Costerton JW. Identification of microbial biofilms in osteonecrosis of the jaws secondary to bisphosphonate therapy J Oral Maxillofac Surg 2008; 66 (4 ) : 767-5. J Am Dent Assoc Sedghizadeh PP 140 1259 2009 Sedghizadeh PP, Kumar SK, Gorur A, Schaudinn C, Shuler CF, Costerton JW. Microbial biofilms in osteomyelitis of the jaw and osteonecrosis of the jaw secondary to bisphosphonate therapy J Am Dent Assoc 2009; 140 (10 ) : 1259-65. J Mater Sci Mater Med Ganguli A 16 283 2005 Ganguli A, Steward C, Butler SL. Bacterial adhesion to bisphosphonate coated hydroxyapatite J Mater Sci Mater Med 2005; 16 (4 ) : 283-7. Biofouling Kopel M 27 701 2011 Kopel M, Degtyar E, Banin E. Surface acoustic waves increase the susceptibility of Pseudomonas aeruginosa biofilms to antibiotic treatment Biofouling 2011; 27 (7 ) : 701-10.